Research Request Form
One inquiry per letter
Juniper Branch of Family Finders
21 SE “D” Street
Madras, OR 97741
541 475-9745
jbff@madras.net
Your Name: _______________________________________ Date____________
Your Address: Street_________________________________________________
City___________________________ State_________ Zip____________________
Phone Number:__________________ Email_______________________________
Name of Person or Subject of your
inquiry__________________________________________
Dates of residence or occurrence in Jefferson County (approx. if
exact date unknown)
_________________________________________ ________
Place of residence: Town______________________ City_______________________________
County___________________________Other ________________________________________
Exact (or approx) year of birth ______________________ year of death ______________ ____
Please state briefly what information you need: _______________________________________
_____________________________________________________________________ _____
Cite any sources you have already checked__________________________________________
_____________________________________________________________________________
Please remit $10.00 for the first hour of research with this request form.
Note that information gathered may be kept on file and made available to other researchers
Please allow 2-4 weeks
Signature____________________________________________________________
*FOR OFFICE USE ONLY
Date received & logged by Assigned to Date completed Comments
_________________________________________________________________________